REV-16-3168BUILDING
PERMIT APPLICATION
r UILDING ❑ ELECTRIC
PLUMBING ❑ MECHANICAL
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
Master Permit N
RECEIVED
YV 1810
FBC 20
Sub Permit No. ci)-'e 1 {c", —31(0B
❑ ROOFING V`REVISION ❑ EXTENSION El RENEWAL
❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: /aro (V /0 5- & r
City: Miami Shores County: Miami Dade Zip: 3,&.13
Folio/Parcel#: 11-22.1 Z a fl2 g® f O 4 0 Is the Building Historically Designated: Yes NO NC
Occupancy Type: Load:
Construction Type: Flood Zone:
OWNER: Name (Fee Simple Titleholder): A 0 �0 f 1%{`� i!� o Au. LiAe/
Address: /Qt(0 /14i! /a c' FL
rf'b1 /�A/m l S II Jf /� tr1 State: L
Tenant/Lessee/Name: WA -
Email: PALLUARt NC
BFE: FFE:
Phone#: 36 4S ? f3I
Zip: S/31
CONTRACTOR: Company Name: _
Address: /655-7 5-64) _94-1- sr -
City: State: /P
Qualifier Name: (j State Certification Certification or Registration #:
DESIGNER: Architect/Engineer:
Address: eR
Value of Work for this Permit: $ 000 1�0
I
Co ry
Phone#:
� .�
7F6 2- 1 I o
Zip: 3 3c1
Phone#: 726 Z STS t `r$�O
A _ �q Certificate of Competency #:
C:VIUL rA la/�N
AR CA/ /TeX 17.17.4/81i/�Phone: 3o r trrx oggo
63 0 �v!!� $S 7" city:C CONMT 'O te: Fi.• zip: 3 3,33
Square/Linear Footage of Work:
Type of Work: ❑ Addition La Alteration ❑yN�ew�ry� E]Repair/Replace E] Demolition
Description of Work: T ?V ptiUR JAI O £ `ra
DNA' WASP /IJ— /N-277111.4 j1//`' 1,10 NAVA/ /A/ /A1 /EY'�,
c/A/IJ 70/tE r
Specify color of color thru tile:
Submittal Fee $ Permit Fee $ 1 (30 • 03 CCF $ C) .
Scanning Fee $ A • Q Radon Fee $ 2 •00 DBPR $ 2 • CO
Technology Fee $ 0 eo Training/Education Fee $ 0 20
Structural Reviews $ S
(Revlsed02/24/2014)
co/cc $
Notary$ J' • OD
Double Fee $
Bond $
0
0
TOTAL FEE NOW DUE $ 1 113EI . Q
Bonding Company's Name (if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property -is subject to attachment. Also, acertified copy ofthe recorded notice of cammenceme►rrrnust be pastezi`arfhe job- sire
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will ,tiiV.,__. y'ro „+and a reinspection ill be charged.
Signature
OWNER or AGENT
The foregoing instrument/was acknowledged before me this
le day of L �en`.1-cmg, 20 ((ji , by
%U E. c(2 -Ger Is p sonally known to
me or who has produced
identification and who did take an oath.
NOTARY PUB C:
Sign:
Print: c )
Seal:
**********
'o � Notary Public State of Florida
Sindia Alvarez
My Commission FF 156750
APPROVED BY
(Revised02/24/2014)
CONTRACTOR
The foregoing instrument was acknowledged before me this
f C day of a//04 1/ , 20 / fro , by
Av`3' 1-4-Z1n/ho is personally known to
me or who has produced (JJP L
identification and who did take an oath.
NOTARY PUBLIC:
as
Sign:
Print:
Seal:
Plans Examiner
Structural Review
Notary PublicMa State of Florida
f Marlene Martinez
'9 My Commission FF 906579
'PO Or Expires 08/04/2019
*
*
**********
Zoning
Clerk
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395
2601 BLAIR STONE ROAD
TALLAHASSEE FL 32399-0783
HERNANDEZ, LUIS
L & J CONSTRUCTION LLC
16351 SW 285TH STREET
HOMESTEAD FL 33033-1034
Congratulations! With this license you become one of the nearly
one million Floridians licensed by the Department of Business and
Professional Regulation. Our professionals and businesses range
from architects to yacht brokers, from boxers to barbeque
restaurants, and they keep' Florida's economy strong.
Every day we work to improve the way we do business in order
to serve you better. For information about our services, please
log onto www.myfloridalicense.com. There you can find more
information about our divisions and the regulations that impact
you, subscribe to department newsletters and leam more about
the Department's initiatives.
Our mission at the Department is: License Efficiently, Regulate
Fairly. We constantly strive to serve you better so that you can
serve your customers. Thank you for doing business in Florida,
and congratulations on your new license!
RICK SCOTT, GOVERNOR
. STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND
•••.,t1 PROFESSIONAL REGULATION
CFC1427776 ISSUED: 07/05/2016
CERTIFIED PLUMBING CONTRACTOR
HERNANDEZ, LUIS
L & J CONSTRUCTION. LLC
IS CERTIFIED under the provisions of Ch.489 FS.
Expiation date : AUG 31, 2018 11807050001144
DETACH HERE
KEN LAWSON, SECRETARY
STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
The PLUMBING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2018
HERNANDEZ, LUIS
L & J CONSTRUCTION LLC
16351 SW 285TH STREET
HOMESTEAD FL 33033-1034
ISSUED: 07/05/2016 DISPLAYAS REQUIRED RY I AW
CGA ll I
010243
Local Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL - DO NOT PA3
6281190
BUSINESS NAME/LOCATION
L & 1 CONSTRUCTION LLC
16351 SW 285 ST
MIAMI FL 33033
OWNER
L & J CONSTRUCTION LLC
LUIS HERNANDEZ QUALIFIER
Worker(s) 1
RECEIPT NO.
RENEWAL
6646882
LBT
EXPIRES
SEPTEMBER 30, 2017
Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
SEC. TYPE OF BUSINESS
196 PLUMBING CONTRACTOR
CFC1427776
PAYMENT RECEIVED
BY TAX COLLECTOR
$75.00 07/14/2016
CHECK21-16-085461
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276.
For more information, visit www.miamidade.gov/taxcoilector